Active NPI
Christopher D Stephan, M.S., ATC, PTA
- Athletic Trainer
- Cleveland, OH
National Provider Identifier
1487667648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 18101 Lorain Ave
Cleveland, OH 44111-5612 - Phone
- (216) 476-7000
- NPI assigned
- Aug 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary | ||
| Physical Therapy Assistant | 225200000X | PTA.08816 | OH |
Addresses
Primary practice location
18101 Lorain Ave
Cleveland, OH 44111-5612
Mailing address
5504 Pleasant St
North Ridgeville, OH 44039-2254
Phone (330) 618-3942
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA.08816 | OH | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402099200000",
"number": "1487667648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5504 PLEASANT ST",
"city": "NORTH RIDGEVILLE",
"state": "OH",
"postal_code": "440392254",
"telephone_number": "330-618-3942"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18101 LORAIN AVE",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441115612",
"telephone_number": "216-476-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEPHAN",
"first_name": "CHRISTOPHER",
"middle_name": "D",
"credential": "M.S., ATC, PTA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-15",
"last_updated": "2014-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "OH",
"license": "PTA.08816",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.